Parkinson's Disease

Parkinson's Disease – General Information

Parkinson’s Disease is a disorder which can affect the nervous system’s muscle control. This disease has been named after the famous physician James Parkinson, who has first deciphered it in 1817. He studied six patients having the same symptoms and eventually named the disease paralysis agitans, which means “shaking palsy” in English. This disorder might be mistaken for other diseases which affect the nervous system. These diseases are called the Parkinson Plus diseases, and have some similar symptoms. Usually the forms of parkinsonism appear as a result of the patient having contact with certain chemical substances, narcotics or viruses. These parkinsonism diseases usually are not affected by the same treatment as the Parkinson’s Disease requires. Doctors also say that the affections which derive from parkinsonism do damage to other parts of the nervous system than the Parkinson’s Disease.
Miami’s National Parkinson Foundation in Florida has estimated that one million and a half Americans are affected by this disorder, but often it’s hard to estimate this because the symptoms of this disease can be often mistaken for those of parkinsonism. The disease occurs all over the world, men catching it more often than women. Caucasians have the greatest incidence of this disease than any other race. This disease usually occurs around ages of 60+, but at least ten percent of the cases are of people who are below 40. There also is a very rare form of the disease which affects teenagers.

Parkinson's Disease – Symptoms

There are four main symptoms that Parkinson’s Disease can present and doctors look for. Tremor can be described as a major shake of limbs and is the main and major symptom which is presented by people who have this disease, although one third of the people who have this disease don’t have this symptom. Tremors might start in one hand and then evolve to the rest of the limb and eventually to your other arm, legs and jaw. This disease may also cause joint inflexibility and painful movement.
Other symptoms:

1. Limb rigidity
2. Bradykinesia (slowness in voluntary moving and speaking)
3. Postural instability
4. Difficulty walking, swallowing
5. Mask-like face
6. Drooling
7. Dizziness in movement from seated to standing position
8. Dementia – thirty percent develop it
9. Failing memory
10. Short attention
11. Personality change
12. Information processing is downgraded and slows – twenty percent – forerunner of dementia
13. Depression, hopelessness, low self-esteem
14. Sadness, apathy, pessimism
15. Anxiety – produces panic attacks
16. Overpowering fears which come with breathlessness, sweat, chest aches, choking and dizziness
17. Insomnia and daytime drowsiness

Parkinson's Disease – Treatment

Parkinson’s Disease has no known cure yet – meaning the doctors do not have any medicine to stop the progress of this disease. But symptoms of this disease may be controlled with drugs and in some cases surgery.

Most Parkinson’s Disease symptoms appear as a result of the lack of dopamine in the head. Injecting dopamine is ineffective, because the transfer between the bloodstream and the brain can’t be done. Anti-Parkinson drugs deploy dopamine to the brain using other methods, or mimic dopamine action.

1. Levodopa
            This is the most efficient anti-parkinson drug available, which was invented in 1967 and treats symptoms like bradykinesia, stiffness, tremor and walking difficulty. When this drug is taken alone, the body breaks is down to about 95 percent to dopamine before it reaches the brain and this fragment is taken to the blood flow, provoking actions like nausea or vomiting before it is metabolized. Observing these side effects, doctors have combined this drug with another one called carbidopa and have created Atamet/Sinemet which is a drug that has the power to take more dopamine to the brain, being more effective against stiffness and bradykinesia, but is less effective against shaking and balance problems. As time passes, the effect of this drug is weakened and patients need larger and larger doses of this product for it to be efficient.

2. Dopamine Agonists
            These drugs activate the nerve cells which are located in the striatum, thus mimicking the actions of dopamine. They are used usually in the early stages of the Parkinson’s Disease, in order to prevent dyskinesia which is caused by the Levodopa drug. In the more advanced stages, this drug will be combined with Levodopa to enhance effects. Side effects can be nausea, headaches, blockage of the nasal passages, nightmares, hallucinations. dopamine agonists are pergolide (Permax), parmipexole (Mirapex) and ropinerole (Requip).

3. Drugs that sustain Levodopa’s effect
            There is a number of drugs which can amplify Levodopa’s effects and sustain them. These are:

1. catechol-O-methyl transferase (COMT) – delays the breakdown of dopamine from Levodopa on it’s way to the brain.
2. MAO-B inhibitors prevent the monoamine oxidaze-B enzyme from breaking down the dopamine on its way to the brain.

Both of these drugs do not prolong Levodopa’s actions.

4. Anticholinergics
            When brain dopamine levels drop, there is another neurotransmitter which is called acetylcholine becomes overactive. This imbalance between dopamine hypoactivity and acetylcholine hyperactivity leads to the problems in the motor system. Anticholinergics block the overpowered actions of the acetylcholine. Drugs like trihexiphenydil (Artane), biperidine (Akineton) are to be used in the primary stages of the Parkinson’s Disease and can diminish tremor and drooling, but are ineffective against posture instability or bradykinesia.

5. Amantadine
            Amantadine, also known as Symetrel, was to be originally made as an antiviral drug, and it was later accidentally found as effective as an antiparkinson drug. Scientists are not yet sure how this drug works.

Some surgical treatments for the Parkinson’s Disease were applied in the 1950-1960’s, but these methods were life-threatening and were soon replaced by Levodopa. Now there is a type of experimental surgery in which doctors try to insert dopamine-producing tissues into the brain.